[Electro-vectorcardiographic diagnosis of left ventricular hypertrophy in the presence of anterior fascicular block].

The aim of this study is to value the utility of the electro-vectorcardiographic criteria of left ventricular hypertrophy (LVH) in presence of the anterior fascicular block (LAFB) utilizing as "gold-standard" the left ventricular mass (LVM) determined by bidimensional echocardiogram (Eco2D). Fifty-four patients with LAFB type IV (S3 greater than 1.5 mV) (age: 58 +/- 10 years) have been studied. Thirty normal subjects have been studied as case control. MVS has been estimated by the method of Reichek. Through estimated parameters, the association of two criteria RI + SIII greater than 2.5 mV and AQRS greater than--45 degrees has shown a high sensitiveness, but a low specificity; so the association of this two criteria is'not sufficient to identify the LVH. In the presence of LAFB the voltages increase in the frontal plane is a constant finding while in the precordial leads is a less constant repeat as LVH manifestation. As a matter of fact the QRS loop tend to be pushed more towards the high and posteriorly. The delay of intrinsic deflections can be observed only in the strict hypertrophy with a without LAFB. The repolarization anomalies with the LAFB presence are more frequent. The electric signs specificity is different. She is good for all except for the repolarization alterations, especially if limited to the T-wave. So in the LAFB type IV of ten increase the QRS voltage in the frontal plane and we can see therefore Lewis' index increased without necessary subtending a LVH.(ABSTRACT TRUNCATED AT 250 WORDS)